Liking yourself just the way you are

Mark Boster / Los Angeles Times

Fashion and beauty icon Lauren Hutton knows how to play to her strengths. Hutton is wearing a Thakoon dress, Alexander Wang blazer, Lulu Frost for Chris Benz necklaces. She was styled by Times style and market editor Melissa Magsaysay.

Fashion and beauty icon Lauren Hutton knows how to play to her strengths. Hutton is wearing a Thakoon dress, Alexander Wang blazer, Lulu Frost for Chris Benz necklaces. She was styled by Times style and market editor Melissa Magsaysay. (Mark Boster / Los Angeles Times)

You know it's tough out there when fashion and beauty executives think that even a model's body isn't good enough to sell clothes or that a celebrity's natural face isn't up to par, even with makeup.

The website Jezebel reported in early December that Swedish retailing giant H&M featured images on its website of lingerie shown on "completely virtual" computer-generated bodies with real models' heads superimposed on top. Meanwhile the British Advertising Standards Authority banned two makeup ads in 2011 featuring Christy Turlington and Julia Roberts because they thought too much airbrushing made the ads misleading, and CoverGirl pulled a mascara ad after a U.S. watchdog agency questioned product claims and post-production enhancement of the photo.

An H&M official defended his company's practice, saying "It's not about ideals or to show off a perfect body … we are doing this to show off the garments."

But faced with an onslaught of digitally enhanced or photo-shopped images, many girls and women find it challenging not to compare and despair. In a currently airing public service announcement produced by the Alliance for Women in Media and the Dove Self-Esteem campaign, broadcaster Lisa Ling cites Dove research that found only 4% of women around the world think they're beautiful.

Even celebrities lauded for their beauty — such as Jane Fonda and Megan Fox — have admitted to insecurities about their looks. "Glee's" Leah Michele says she was told she'd never make it because of her nose, and some stars have acknowledged eating disorders. "I get a very interesting perspective because I work with the most beautiful women in the world who don't always view themselves as the most beautiful women in the world," says celebrity makeup artist Sam Fine, the creative makeup director for Fashion Fair Cosmetics who's also been a spokesman for Revlon and CoverGirl, worked on myriad magazine covers and done make-up for renowned beauties such as Iman and Vanessa Williams.

Fine's solution is to use makeup to bring attention to the person's favorite feature. "If you want to bring attention from your smaller lips to your bigger eyes, then that means a lash and a beautiful brow … you can also de-emphasize areas with contour," he says, adding that in many ways there's a growing diversity in the beauty industry. "Don't compare yourself to someone else's standard of beauty," Fine says. "Realize that your eyes aren't Iman's eyes, but we can bring out your eyes, your beauty."

But sometimes makeup isn't enough. A change in thinking is called for.

"It's very normal for people to be unhappy with their appearance," psychologist Sabine Wilhelm says.

Wilhelm is an expert on what happens when this dissatisfaction is taken to an extreme, when people have such raging negativity about their looks that it "really interferes with having a good life." As an example she cites "someone who says, 'I'm just too ugly to go out today because my skin broke out.'"

About 2% of the population has what's called Body Dysmorphic Disorder (BDD), she says, in which minor imperfections are perceived as major and cause stress out of proportion to the reality. Wilhelm knows this territory well. She is director of both the obsessive compulsive and related disorders program and the cognitive-behavior therapy program at Massachusetts General Hospital/Harvard Medical School, where she is an associate professor of psychology, and founder of the hospital's BDD clinic and research unit. She wrote a book about the issue, "Feeling Good About the Way You Look: A Program for Overcoming Body Image Problems."

Her techniques for working with BDD patients can be translated into advice for others who are trying to feel more confident about their looks.

Acknowledge that negative thoughts may not be reality: Consider this example: A person may spend hours per day thinking about a scar that, in fact, no one else notices. This is a disconnect between the person's body image and actual appearance.

"Very often patients with body image concerns engage in a lot of mind reading. They automatically assume that other people are reacting negatively to them even though they have no evidence for that whatsoever," Wilhelm says. Think everyone looking at you is thinking how big your nose is? "Examine how helpful, accurate or valid your thinking is," Wilhelm says. "Ask, 'Is there any other thing that supermarket clerk might have been thinking when he smiled at me?' Well yeah, he may have just been being a friendly guy.... The world doesn't revolve around your nose. That particular approach is called 'cognitive restructuring' — learning to step back from your thoughts and evaluate them more critically."

Inventory all your assets: Many with body image issues selectively focus on whatever body part they dislike. In therapy, Wilhelm helps patients see a broader perspective and shift the emphasis away from appearance to other assets. Often, she says, people with body image issues disregard their other talents. Perhaps the client sings beautifully, writes poetry, has a terrific work ethic, is really smart or is a good daughter or friend.

"The average person doesn't have just one dimension that they base their self-worth on," Wilhelm says. "There are many facets of yourself that you can draw self-esteem from."

Cut down on appearance rituals: Wilhelm's patients might say that they feel better if they apply four layers of concealer before going out, but the good feeling is short-term. In the long run, the routine traps them and keeps the anxiety going. One therapeutic solution is to reduce grooming rituals that are based on the belief that it's important to hide or fix problems.

"We talk about whether those appearance rituals or avoidance behaviors have really helped them or not. Often the answer is no," Wilhelm says.

Learn to be objective: Wilhelm says that BDD sufferers have "all or nothing" thinking. They divide people into two categories: beautiful or ugly, models or monsters. One perceived flaw makes the difference.

A practical mirror exercise keeps the person from zooming in to focus on the body part causing concern — big ears, say — by instead standing in front of the mirror and describing herself from top to bottom in very objective, nonjudgmental terms: "I'm 5 feet 8, my hair is brown, my eyes are green."

Wilhelm says that people with body image issues interpret their "uniqueness" in a totally different way. "They might think, 'I look different, therefore I have a deformity and therefore I'm abnormal, ashamed.' And then they engage in all kinds of appearance-fixing behaviors, even to the point of cosmetic surgery," she says.

People with a real disfigurement may feel increased self-esteem after surgery, but people with BDD who have surgery to correct a perceived flaw "often don't feel any better about their appearance," she says. "Surgery is definitely not the answer because in cases like this, the flaw is not a physical one; it's an internal problem.... In therapy, people really learn to expose those things that they're struggling with. We reduce [a woman's] avoidance behavior by having her flaunt her nose, so to speak, but we also examine her thinking around the nose and show her nothing bad is going to happen if you take the risk" of showing it off.

Getting professional help: For that small percentage of people who aren't simply insecure but who do have BDD, it's important to get professional help. The condition is often accompanied by depression that can lead to suicidal thoughts and substance abuse.

Wilhelm says that it is not uncommon for people to think that a loved one is merely vain when the problem is actually BDD. "These issues start around adolescence and usually won't go away without professional help," she says.

"Don't get stuck in an argument with them about whether the flaw is real or not," she advises. Instead, focus on the person's suffering and address it directly. For instance, say you've noticed how much they're struggling or how anxious and sad they seem. Say, for example, "Honey I've noticed that you spend an awful lot of time in front of the mirror and you keep asking me about your hair several times a day," or "I've noticed that you're not going out with your friends as much."

To a teenager, Wilhelm suggests following with, "I'm worried that you have a problem and that you need professional help." For an adult, you might provide a book on the subject and say, "You may have a problem called Body Dysmorphic Disorder, and here I have a book for you. Why don't you take a look at it and see if any of the descriptions sound familiar?"

The good news? "There is actually really good treatment out there now," she says, citing cognitive behavior and pharmaceutical therapy.